Improve your engagement and support for individuals with schizophrenia with the guidance of NAMI’s Schizophrenia and Psychosis Lexicon Guide. This resource merges professional insights with lived experiences to recommend language that conveys respect, understanding, and support. Essential for anyone communicating about schizophrenia, this guide is a step towards more effective and empathetic conversations. Enhance your communication—download the guide today.
Schizophrenia is a serious mental illness that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It is a complex, long-term medical illness. The exact prevalence of schizophrenia is difficult to measure, but estimates range from 0.25% to 0.64% of U.S. adults. Although schizophrenia can occur at any age, the average age of onset tends to be in the late teens to the early 20s for men, and the late 20s to early 30s for women. It is uncommon for schizophrenia to be diagnosed in a person younger than 12 or older than 40. It is possible to live well with schizophrenia.
It can be difficult to diagnose schizophrenia in teens. This is because the first signs can include a change of friends, a drop in grades, sleep problems, and irritability—common and nonspecific adolescent behavior. Other factors include isolating oneself and withdrawing from others, an increase in unusual thoughts and suspicions, and a family history of psychosis. In young people who develop schizophrenia, this stage of the disorder is called the “prodromal” period.
With any condition, it’s essential to get a comprehensive medical evaluation in order to obtain the best diagnosis. For a diagnosis of schizophrenia, some of the following symptoms are present in the context of reduced functioning for a least 6 months:
Hallucinations. These include a person hearing voices, seeing things, or smelling things others can’t perceive. The hallucination is very real to the person experiencing it, and it may be very confusing for a loved one to witness. The voices in the hallucination can be critical or threatening. Voices may involve people that are known or unknown to the person hearing them.
Delusions. These are false beliefs that don’t change even when the person who holds them is presented with new ideas or facts. People who have delusions often also have problems concentrating, confused thinking, or the sense that their thoughts are blocked.
Negative symptoms are ones that diminish a person’s abilities. Negative symptoms often include being emotionally flat or speaking in a dull, disconnected way. People with the negative symptoms may be unable to start or follow through with activities, show little interest in life, or sustain relationships. Negative symptoms are sometimes confused with clinical depression.
Cognitive issues/disorganized thinking. People with the cognitive symptoms of schizophrenia often struggle to remember things, organize their thoughts or complete tasks. Commonly, people with schizophrenia have anosognosia or “lack of insight.” This means the person is unaware that he has the illness, which can make treating or working with him much more challenging.
Research suggests that schizophrenia may have several possible causes:
Diagnosing schizophrenia is not easy. Sometimes using drugs, such as methamphetamines or LSD, can cause a person to have schizophrenia-like symptoms. The difficulty of diagnosing this illness is compounded by the fact that many people who are diagnosed do not believe they have it. Lack of awareness is a common symptom of people diagnosed with schizophrenia and greatly complicates treatment.
While there is no single physical or lab test that can diagnosis schizophrenia, a health care provider who evaluates the symptoms and the course of a person’s illness over six months can help ensure a correct diagnosis. The health care provider must rule out other factors such as brain tumors, possible medical conditions and other psychiatric diagnoses, such as bipolar disorder.
To be diagnosed with schizophrenia, a person must have two or more of the following symptoms occurring persistently in the context of reduced functioning:
Delusions or hallucinations alone can often be enough to lead to a diagnosis of schizophrenia. Identifying it as early as possible greatly improves a person’s chances of managing the illness, reducing psychotic episodes, and recovering. People who receive good care during their first psychotic episode are admitted to the hospital less often, and may require less time to control symptoms than those who don’t receive immediate help. The literature on the role of medicines early in treatment is evolving, but we do know that psychotherapy is essential.
People can describe symptoms in a variety of ways. How a person describes symptoms often depends on the cultural lens she is looking through. African Americans and Latinos are more likely to be misdiagnosed, potentially due to differing cultural perspectives or structural barriers. Any person who has been diagnosed with schizophrenia should try to work with a health care professional that understands his or her cultural background and shares the same expectations for treatment.
There is no cure for schizophrenia, but it can be treated and managed in several ways.
People with schizophrenia may have additional illnesses. These may include:
Successfully treating schizohprenia almost always improves these related illnesses. And successful treatment of substance misuse, PTSD or OCD usually improves the symptoms of schizophrenia.
With medication, psychosocial rehabilitation, and family support, the symptoms of schizophrenia can be reduced. People with schizophrenia should get treatment as soon as the illness starts showing, because early detection can reduce the severity of their symptoms.
Recovery while living with schizophrenia is often seen over time, and involves a variety of factors including self-learning, peer support, school and work and finding the right supports and treatment.
Typically, a health care provider will prescribe antipsychotics to relieve symptoms of psychosis, such as delusions and hallucinations. Due to lack of awareness of having an illness and the serious side effects of medication used to treat schizophrenia, people who have been prescribed them are often hesitant to take them.
These medications can cause serious movement problems that can be short (dystonia) or long term (called tardive dyskinesia), and also muscle stiffness. Other side effects can also occur.
These medications are called atypical because they are less likely to block dopamine and cause movement disorders. They do, however, increase the risk of weight gain and diabetes. Changes in nutrition and exercise, and possibly medication intervention, can help address these side effects.
One unique second generation antipsychotic medication is called clozapine. It is the only FDA approved antipsychotic medication for the treatment of refractory schizophrenia and has been the only one indicated to reduce thoughts of suicide. However, it does have multiple medical risks in addition to these benefits.
Cognitive behavioral therapy (CBT) is an effective treatment for some people with affective disorders. With more serious conditions, including those with psychosis, additional cognitive therapy is added to basic CBT (CBTp). CBTp helps people develop coping strategies for persistent symptoms that do not respond to medicine.
Supportive psychotherapy is used to help a person process his experience and to support him in coping while living with schizophrenia. It is not designed to uncover childhood experiences or activate traumatic experiences, but is rather focused on the here and now.
Cognitive Enhancement Therapy (CET) works to promote cognitive functioning and confidence in one’s cognitive ability. CET involves a combination of computer based brain training and group sessions. This is an active area of research in the field at this time.
People who engage in therapeutic interventions often see improvement, and experience greater mental stability. Psychosocial treatments enable people to compensate for or eliminate the barriers caused by their schizophrenia and learn to live successfully. If a person participates in psychosocial rehabilitation, she is more likely to continue taking their medication and less likely to relapse. Some of the more common psychosocial treatments include:
Complementary and alternative health approaches including acupuncture, meditation, and nutrition interventions can be part of a comprehensive treatment plan. For example, Omega-3 fatty acids, commonly found in fish oil, have shown some promise for treating and managing schizophrenia. Some researchers believe that omega-3 may help treat mental illness because of its ability to help replenish neurons and connections in affected areas of the brain.
Physical Health. People with schizophrenia are subject to many medical risks, including diabetes and cardiovascular problems, and also smoking and lung disease. For this reason, coordinated and active attention to medical risks is essential.
Substance Use. People with schizophrenia are at an increased risk for misusing drugs or alcohol. Substance use can make the treatments for schizophrenia less effective, make people less likely to follow their treatment plans, and even worsen their symptoms.
Coping with schizophrenia isn’t easy. But if you or a family member or friend is struggling, there is help. NAMI and NAMI Affiliates are here to provide you with support for you and your family and information about community resources. Contact the NAMI HelpLine at 1-800-950-NAMI (6264) or [email protected] if you have any questions about schizophrenia or finding support and resources.
If you have schizophrenia, the condition can exert control over your thoughts, interfere with functioning and if not treated, lead to a crisis. Here are some ways to help manage your illness.
If you live with a mental health condition, learn more about managing your mental health and finding the support you need.
Learning about psychosis and schizophrenia will help you understand what your friend or family member is experiencing and trying to cope with. Living with schizophrenia is challenging. Here are some ways you can show support:
Find out more about taking care of your family member or friend and yourself.
NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).
